摘要
为观察鼻内镜术后糖皮质激素浸润对慢性鼻-鼻窦炎伴鼻息肉患者近期疗效及嗅觉功能的影响。我们收集2010年01月~2012年01月诊治的慢性鼻-鼻窦炎伴鼻息肉患者的临床资料,共118例纳入本次研究,按随机法分为观察组(n=59)和对照组(n=59),两组患者均接受Messerklinger术式单行鼻内镜手术,术后观察组患者给予糖皮质激素(布地奈德鼻喷剂)喷鼻,2次/d,1喷/次,持续治疗半年。对照组患者术前处理和手术方法同观察组,术后除不使用布地奈德喷剂喷鼻处理,其余方法及定期进行鼻内镜复查同观察组。观察比较两组患者治疗总有效率、术后复发率、鼻气道阻力及嗅觉功能改善情况。结果显示,观察组54例显效(总有效率91.52%),对照组显效43例(总有效率72.88%),两组总疗效比较差异显著(p<0.05),且在半年复发率方面观察组(6.78%)显著低于对照组(20.34%)(p<0.05);术后,两组鼻气道阻力及嗅觉功能均较术前明显改善(p<0.05),且观察组术后1、4、12、24周两项指标评定结果均优于对照组(p<0.05),且观察组术后用药并未增加不良反应,两组对比无统计学意义(p<0.05)。鼻内镜术后应用糖皮质激素浸润治疗慢性鼻-鼻窦炎伴鼻息肉患者疗效安全,通过缓解患者鼻腔内炎症反应来减轻患者临床症状,同时促进鼻腔功能恢复,术后复发率低,值得临床推广使用。
To observe the effect of glucocorticoid infiltration on the short-term curative effect and olfactory functions in patients with chronic rhinosinusitis complicated with nasal polyps after endoscopic sinus surgery, 118 patients with chronic rhinosinusitis complicated with nasal polyps, who were treated in the outpatient department of Otorhinolaryngology in our hospital from January, 2010 to January, 2012, were selected as the study subjects and were randomized into observation group and control group, 59 cases in each group. Both groups were treated by Messeklinger type single-way endoscopic sinus surgery. The observation group was treated with budesonide nasal spray, twice a day, one spray at each time, and for six months. The treatment and surgical methods of thecontrol group before surgery were the same as those of the observation group, but after surgery, the control group was not treated with budesonide nasal spray. The other methods and regular nasal endoscopy of the control group were the same with observation group. The total effective rate, postoperative recurrence rate, nasal airway resistance and improvement of olfactory functions were observed and compared between the two groups. The total effective rate in the observation group （91.52%） was significantly higher than that in the control group （72.88%）, and the recurrence rate of observation group within six months was significantly lower than that of the control group （p 〈0.05）. After the operation, the nasal airway resistance and olfactory functions improved significantly （p〈0.05）. At the 1st week, 44 week, 124 week and 24~ week after surgery, the nasal airway resistance and olfactory functions in observation group was significantly superior to those in control group （p 〈0.05）. Meanwhile, no adverse reaction has occurred to the observation group and the comparison between the two groups is not statistically significant （p〈0.05）. After applying glucocorticoid infiltration in the treatment of patients with chronic rhinosinusitis complicated with nasal polyps after endoscopic sinus surgery, the curative effect was significant and the postoperative recurrence rate was low. It could effectively relieve the clinical symptoms and improve olfactory function in patients. It was worthy of clinical application.
出处
《基因组学与应用生物学》
CAS
CSCD
北大核心
2017年第7期2722-2727,共6页
Genomics and Applied Biology
基金
十堰市科学技术研究及开发项目(15Y303)资助
关键词
慢性鼻鼻窦炎
鼻内镜手术
布地奈德
嗅觉
Chronic rhinosinusitis, Endoscopic sinus surgery, Budesonide, Olfactory function
